Abstract

The Aim of this study was to evaluate retrospectively the clinical prognostic parameters of children with diagnosed invasive meningococcal disease (IMD) during their admission to the emergency department and compare them to clinical diagnosis and outcome.

Methods We retrospectively evaluated 75 patients admitted to the PICU of Vilnius University Children’s Hospital during 2009–2010 years. IMD with meningitis was diagnosed in 32 patients (McM group), meningococcemia and septic shock without meningitis in 43 patients (Mc group). 6 patients died (8%), 5 in Mc group (11.6%), and 1 in McM group (3.1%). 6 bad prognosis parameters (BPP) during admission were evaluated:

short duration of illness before admission (less than 24 hours),

widespread haemorrhagic rash,

signs of septic shock,

alert state of consciousness,

blood leukocyte count < 10×109/L,

blood platelet count < 100×s109/L.

Results All 6 BPP were established in 6 Mc group patients, 5 of them died, all have duration of illness less than 12 hours. 4 or more BPP was in 16 (37.2%) Mc group patients, and in 6 (18.7%) McM (p>0.05). 3 or less BPP was equal in both groups. More than 2 BPP was established statistically significant more often in Mc patients group - 60.5% and 34.4% (p=0.036).

Conclusions An early identification child with meningococcal sepsis without meningitis is important to start the appropriative treatment as soon as possible. 2 or more BPP during the first assessment in the emergency department can be predictive values of the life threatening process of meningococcal infection.

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